• Business Financing Application

    Business Financing Application

    Email - submissions@thebrokershopinc.com
  • Let's get to know your Business

  • Start Date
     / /
  • Format: (000) 000-0000.
  • How do we contact you?

  • Best way to reach you with updates
  • Format: (000) 000-0000.
  • Funding Request:

  • Do you currently have a Business Loan or Cash Advance?
  • Date of last advance
     / /
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  • 1st Owner/ Principal Information

  • Date of Birth
     / /
  • 2nd Owner Information

  • Date of Birth
     / /
  • PROGRAM QUALIFYING QUESTIONS

  • Is the Business Seasonal?
  • Do you have new projects/contracts?
  • Does the business take CC Payments?
  • Do you have any open Federal or State Judgements
  • Do you have any open Bankruptcies?
  • Have you defaulted on a loan in the past?
  • If Yes*, are they paid off?
  •  

    The Merchant and Owner(s)/Officer(s) identified above (individually, an "Applicant") each represents, acknowledges, and agrees that (1) all information and documents provided to The Broker Shop, Inc. here by known as ("TBS") are true, accurate, and complete, (2) Applicant will immediately notify TBS of any change in such financial condition, (3) TBS and its' agents are authorized to request and receive any investigative reports, credit reports, statements from creditors or financial institutions, verification of information, or any other information that TBS and its' agents deem necessary, (4) Applicant waives and releases any claims against TBS and any information-providers arising from any act or omission relating to the requesting, receiving, or release of information, (5) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant, and (6) the Merchant and each Owner/Officers agrees to receive calls, texts, emails or mail from TBS or its agents.

  • 1st Owner/ Principal Officer

  • Date Signed
     - -
  • 2nd Owner

  • Date Signed
     - -
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